Screening for Depression among Community-dwelling Elders: Usefulness of the Center for Epidemiologic Studies Depression Scale

CONTEXT Though common, depressive disorders often remain undetected in late life. AIM To examine the usefulness of Center for Epidemiologic Studies Depression (CES-D) for identifying depression among older people. SETTINGS AND DESIGN Community resident older people (aged 65 years or more), were evaluated by clinicians trained in psychiatry, as part of a cross-sectional study of late-life depression. Assessments were done in the community. METHODS AND MATERIAL The participants were assigned ICD-10 diagnoses and assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and CES-D. A short version of CES-D with 10 items, translated to the local language Malayalam, was used. STATISTICAL ANALYSIS The sensitivity and specificity of CES-D was evaluated against ICD-10 clinical diagnosis of depression. The correlation of CES-D and MADRS was assessed using Pearson correlation coefficient. RESULTS 220 consenting adults from 3 wards of the Panchayath were assessed. On analysis of the Receiver Operating Characteristic (ROC) curve of CES-D scores in relation to clinical diagnosis, the large Area Under Curve (AUC) showed efficient screening and a cut off score of 4 in CES-D had a sensitivity of 97.7% and a specificity of 79.1% for depression. There was also good correlation between the MADRS and CES-D scores (0.838). CONCLUSION CES-D is a short simple scale which can be used by health care professionals for detecting depression in older people in primary care settings.